What you need to know about FLiRT, an emerging group of COVID-19 variants

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What you need to know

  • COVID-19 wastewater levels are currently low, but a recent group of variants called FLiRT is making headlines.
  • KP.2 is one of several FLiRT variants, and early lab tests suggest that it’s more infectious than JN.1.
  • Getting infected with any COVID-19 variant can cause severe illness, heart problems, and death.

KP.2, a new COVID-19 variant, is now dominant in the United States. Lab tests suggest that it may be more infectious than JN.1, the variant that was dominant earlier this year.

Fortunately, there’s good news: Current wastewater data shows that COVID-19 infection rates are low. Still, experts are closely watching KP.2 to see if it will lead to an uptick in infections.

Read on to learn more about KP.2 and how to stay informed about COVID-19 cases in your area.

Where can I find data on COVID-19 cases in my area?

Hospitals are no longer required to report COVID-19 hospital admissions or hospital capacity to the Department of Health and Human Services. However, wastewater-based epidemiology (WBE) estimates the number of COVID-19 infections in a community based on the amount of COVID-19 viral particles detected in local wastewater.

View this map of wastewater data from the CDC to visualize COVID-19 infection rates throughout the U.S., or look up COVID-19 wastewater trends in your state.

What do we know so far about the new variant?

Early lab tests suggest that KP.2—one of a group of emerging variants called FLiRT—is similar to the previously dominant variant, JN.1, but it may be more infectious. If you had JN.1, you may still get reinfected with KP.2, especially if it’s been several months or longer since your last COVID-19 infection.

A CDC spokesperson said they have no reason to believe that KP.2 causes more severe illness than other variants. Experts are closely watching KP.2 to see if it will lead to an uptick in COVID-19 cases.

How can I protect myself from COVID-19 variants?

Staying up to date on COVID-19 vaccines reduces your risk of severe illness, long COVID, heart problems, and death. The CDC recommends that people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring.

Wearing a high-quality, well-fitting mask reduces your risk of contracting COVID-19 and spreading it to others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of COVID-19.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Safe Effective Sleep Aids For Seniors

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    Safe Efective Sleep Aids For Seniors

    Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:

    Review of Safety and Efficacy of Sleep Medicines in Older Adults

    Let’s break it down…

    What’s not so great

    Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.

    Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.

    Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.

    See also: Benzodiazepine and z-drug withdrawal

    (and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)

    Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.

    What about cannabis products?

    We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.

    How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.

    Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.

    See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

    Melatonin: a powerful helper with a good safety profile

    We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.

    Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:

    Melatonin: A Safe Natural Sleep Supplement

    Herbal options: which really work?

    Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.

    See: Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

    Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).

    But here’s one study that found it helped significantly:

    The effects of chamomile extract on sleep quality among elderly people: A clinical trial

    Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!

    Technological interventions

    We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:

    White Noise Is Good; Pink Noise Is Better

    Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.

    We reviewed some sleep apps; you might like those too:

    The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

    Enjoy, and rest well!

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  • Pomegranate vs Cranberries – Which is Healthier?

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    Our Verdict

    When comparing pomegranate to cranberries, we picked the pomegranate.

    Why?

    Starting with the macros: pomegranate has nearly 4x the protein (actually quite a lot for a fruit, but this is not too surprising—it’s because we are eating the seeds!), and slightly more carbs and fiber. Their glycemic indices are comparable, both being low GI foods. While both of these fruits have excellent macro profiles, we say the pomegranate is slightly better, because of the protein, and when it comes to the carbs and fiber, since they balance each other out, we’ll go with the option that’s more nutritionally dense. We like foods that add more nutrients!

    In the category of vitamins, pomegranate is higher in vitamins B1, B2, B3, B5, B6, B9, K, and choline, while cranberry is higher in vitamins A, C, and E. Both are very respectable profiles, but pomegranate wins on strength of numbers (and also some higher margins of difference).

    When it comes to minerals, it is not close; pomegranate is higher in calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while cranberry is higher in manganese. An easy win for pomegranate here.

    Both of these fruits have additional “special” properties, though it’s worth noting that:

    • pomegranate’s bonus properties, which are too many to list here, but we link to an article below, are mostly in its peel (so dry it, and grind it into a powder supplement, that can be worked into foods, or used like an instant fruit tea, just without the sugar)
    • cranberries’ bonus properties (including: famously very good at reducing UTI risk) come with some warnings, including that they may increase the risk of kidney stones if you are prone to such, and also that cranberries have anti-clotting effects, which are great for heart health but can be a risk of you’re on blood thinners or have a bleeding disorder.

    You can read about both of these fruits’ special properties in more detail below:

    Want to learn more?

    You might like to read:

    Take care!

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  • The “Five Tibetan Rites” & Why To Do Them!

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    Spinning Around

    In Tuesday’s newsletter, we asked you for your opinion of the “Five Tibetan Rites”, and got the above-depicted, below-described, set of responses:

    • About 41% said “I have never heard of these before”
    • About 27% said “they restore youth by adjusting internal vortexes”
    • About 22% said “they are basically yoga, by a different name”
    • About 11% said “they are a pseudoscience popular in the US”

    So what does the science say?

    The Five Tibetan Rites are five Tibetan rites: True or False?

    False, though this is more question of social science than of health science, so we’ll not count it against them for having a misleading name.

    The first known mentioning of the “Five Tibetan Rites” is by an American named Peter Kelder, who in 1939 published, through a small LA occult-specialized publishing house, a booklet called “The Eye of Revelation”. This work was then varyingly republished, repackaged, and occasionally expanded upon by Kelder or other American authors, including Chris Kilham’s popular 1994 book “The Five Tibetans”.

    The “Five Tibetan Rites” are unknown as such in Tibet, except for what awareness of them has been raised by people asking about them in the context of the American phenomenon.

    Here’s a good history book, for those interested:

    The Secret of the Five Rites: In Search of a Lost Western Tradition of Inner Alchemy – by John Michael Greer

    The author didn’t originally set out to “debunk” anything, and is himself a keen spiritualist (and practitioner of the five rites), but he was curious about the origins of the rites, and ultimately found them—as a collection of five rites, and the other assorted advices given by Kelder—to be an American synthesis in the whole, each part inspired by various different physical practices (some of them hatha yoga, some from the then-popular German gymnastics movement, some purely American spiritualism, all available in books that were popular in California in the early 1900s).

    You may be wondering: why didn’t Kelder just say that, then, instead of telling stories of an ancient Tibetan tradition that empirically does not exist? The answer to this lies again in social science not health science, but it’s been argued that it’s common for Westerners to “pick ‘n’ mix” ideas from the East, champion them as inscrutably mystical, and (since they are inscrutable) then simply decide how to interpret and represent them. Here’s an excellent book on this, if you’re interested:

    Orientalism – by Edward Said

    (in Kelder’s case, this meant that “there’s a Tibetan tradition, trust me” was thus more marketable in the West than “I read these books in LA”)

    They are at least five rites: True or False?

    True! If we use the broad definition of “rite” as “something done repeatedly in a solemn fashion”. And there are indeed five of them:

    1. Spinning around (good for balance)
    2. Leg raises (this one’s from German gymnastics)
    3. Kneeling back bend (various possible sources)
    4. Tabletop (hatha yoga, amongst others)
    5. Pendulum (hatha yoga, amongst others) ← you may recognize this one from the Sun Salutation

    You can see them demonstrated here:

    Click Here If The Embedded Video Doesn’t Load Automatically

    Kelder also advocated for what was basically the Hay Diet (named not for the substance but for William Hay; it involved separating foods into acid and alkali, not necessarily according to the actual pH of the foods, and combining only “acid” foods or only “alkali” foods at a time), which was popular at the time, but has since been rejected as without scientific merit. Kelder referred to this as “the sixth rite”.

    The Five Rites restore youth by adjusting internal vortexes: True or False?

    False, in any scientific sense of that statement. Scientifically speaking, the body does not have vortexes to adjust, therefore that is not the mechanism of action.

    Spiritually speaking, who knows? Not us, a humble health science publication.

    The Five Rites are a pseudoscience popular in the US: True or False?

    True, if 27% of those who responded of our mostly North American readership can be considered as representative of what is popular.

    However…

    “Pseudoscience” gets thrown around a lot as a bad word; it’s often used as a criticism, but it doesn’t have to be. Consider:

    A small child who hears about “eating the rainbow” and mistakenly understands that we are all fuelled by internal rainbows that need powering-up by eating fruits and vegetables of different colors, and then does so…

    …does not hold a remotely scientific view of how things are happening, but is nevertheless doing the correct thing as recommended by our best current science.

    It’s thus a little similar with the five rites. Because…

    The Five Rites are at least good for our health: True or False?

    True! They are great for the health.

    The first one (spinning around) is good for balance. Science would recommend doing it both ways rather than just one way, but one is not bad. It trains balance, trains our stabilizing muscles, and confuses our heart a bit (in a good way).

    See also: Fall Special (How To Not Fall, And Not Get Injured If You Do)

    The second one (leg raises) is excellent for core strength, which in turn helps keep our organs where they are supposed to be (this is a bigger health issue than most people realise, because “out of sight, out of mind”), which is beneficial for many aspects of our health!

    See also: Visceral Belly Fat & How To Lose Itvisceral fat is the fat that surrounds your internal organs; too much there becomes a problem!

    The third, fourth, and fifth ones stretch our spine (healthily), strengthen our back, and in the cases of the fourth and fifth ones, are good full-body exercises for building strength, and maintaining muscle mass and mobility.

    See also: Building & Maintaining Mobility

    So in short…

    If you’ve been enjoying the Five Rites, by all means keep on doing them; they might not be Tibetan (or an ancient practice, as presented), and any mystical aspect is beyond the scope of our health science publication, but they are great for the health in science-based ways!

    Take care!

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Related Posts

  • Why is pain so exhausting?
  • Black Olives vs Green Olives – Which is Healthier

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing black olives to green olives, we picked the black olives.

    Why?

    First know this: they are the same plant, just at different stages of ripening (green olives are, as you might expect, less ripe).

    Next: the nutritional values of both, from macros down to the phytochemicals, are mostly very similar, but there are a few things that stand out:
    • Black olives usually have more calories per serving, average about 25% more. But these are from healthy fats, so unless you’re on a calorie-restricted diet, this is probably not a consideration.
    • Green olives are almost always “cured” for longer, which results in a much higher sodium content often around 200% that of black olives. Black olives are often not “cured” at all.

    Hence, we chose the black olives!

    You may be wondering: do green olives have anything going for them that black olives don’t?

    And the answer has a clue in the taste: green olives generally have a stronger, more bitter/pungent taste. And remember what we said about things that have a stronger, more bitter/pungent taste:

    Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain

    That’s right, green olives are a little higher in polyphenols than black olives.

    But! If you want to enjoy the polyphenol content of green olives without the sodium content, the best way to do that is not olives, but olive oil—which is usually made from green olives.

    For more about olive oil, check out:

    All About Olive Oils: Is “Extra Virgin” Worth It?

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  • Driving under the influence of marijuana: An explainer and research roundup

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    Update 1: On May 16, 2024, the U.S. Department of Justice sent a proposed rule to the Federal Register to downgrade marijuana from a Schedule I to a Schedule III drug. This is the first step in a lengthy approval process that starts with a 60-day comment period.

    Update 2: Two recent research studies were added to the “Studies on marijuana and driving” section of this piece on July 18, 2024.

    As marijuana use continues to rise and state-level marijuana legalization sweeps the U.S., researchers and policymakers are grappling with a growing public safety concern: marijuana-impaired driving.

    As of April 2023, 38 U.S. states had legalized medical marijuana and 23 had legalized its recreational use, according to the National Conference of State Legislatures. Recreational or medical marijuana measures are on the ballot in seven states this year.

    The issue of marijuana-impaired driving has not been an easy one to tackle because, unlike alcohol, which has well-established thresholds of impairment, the metrics for marijuana’s effects on driving remain rather elusive.

    “We don’t have that kind of deep knowledge right now and it’s not because of lack of trying,” says Dr. Guohua Li, professor of epidemiology and the founding director of the Center for Injury Science and Prevention at Columbia University.

    “Marijuana is very different from alcohol in important ways,” says Li, who has published several studies on marijuana and driving. “And one of them is that the effect of marijuana on cognitive functions and behaviors is much more unpredictable than alcohol. In general, alcohol is a depressant drug. But marijuana could act on the central nervous system as a depressant, a stimulant, and a hallucinogenic substance.”

    Efforts to create a breathalyzer to measure the level of THC, the main psychoactive compound found in the marijuana plant, have largely failed, because “the THC molecule is much bigger than ethanol and its behavior after ingestion is very different from alcohol,” Li says.

    Currently, the two most common methods used to measure THC concentration to identify impaired drivers are blood and saliva tests, although there’s ongoing debate about their reliability.

    Marijuana, a term interchangeably used with cannabis, is the most commonly used federally illegal drug in the U.S.: 48.2 million people, or about 18% of Americans reported using it at least once in 2019, according to the latest available data from the Centers for Disease Control and Prevention. Worldwide, 2.5% of the population consumes marijuana, according to the World Health Organization.

    Marijuana is legal in several countries, including Canada, where it was legalized in 2018. Despite state laws legalizing cannabis, it remains illegal at the federal level in the U.S.

    As states grapple with the contentious issue of marijuana legalization, the debate is not just about public health, potential tax revenues and economic interests. At the heart of the discussion is also the U.S. criminal justice system.

    Marijuana is shown to have medicinal qualities and, compared with substances like alcohol, tobacco, and opioids, it has relatively milder health risks. However, it’s not risk-free, a large body of research has shown.

    Marijuana consumption can lead to immediate effects such as impaired muscle coordination and paranoia, as well as longer-term effects on mental health and cognitive functions — and addiction. As its use becomes more widespread, researchers are trying to better understand the potential hazards of marijuana, particularly for younger users whose brains are in critical stages of development.

    Marijuana and driving

    The use of marijuana among drivers, passengers and pedestrians has increased steadily over the past two decades, Li says.

    Compared with the year 2000, the proportion of U.S. drivers on the road who are under the influence of marijuana has increased by several folds, between five to 10 times, based on toxicology testing of people who died in car crashes, Li says.

    A 2022 report from the National Transportation Safety Board finds alcohol and cannabis are the two most commonly detected drugs among drivers arrested for impaired driving and fatally injured drivers. Most drivers who tested positive for cannabis also tested positive for another potentially impairing drug.

    “Although cannabis and many other drugs have been shown to impair driving performance and are associated with increased crash risk, there is evidence that, relative to alcohol, awareness about the potential dangers of driving after using other drugs is lower,” according to the report.

    Indeed, many U.S. adults perceive daily marijuana use or exposure to its smoke safer than tobacco, even though research finds otherwise.

    Several studies have demonstrated marijuana’s impact on driving.

    Marijuana use can reduce the drivers’ ability to pay attention, particularly when they are performing multiple tasks, research finds. It also slows reaction time and can impair coordination.

    “The combination is that you potentially have people who are noticing hazards later, braking slower and potentially not even noticing hazards because of their inability to focus on competing things on the road,” says Dr. Daniel Myran, an assistant professor at the Department of Family Medicine and health services researcher at the University of Ottawa.

    In a study published in September in JAMA Network Open, Myran and colleagues find that from 2010 to 2021 the rate of cannabis-involved traffic injuries that led to emergency department visits in Ontario, Canada, increased by 475%, from 0.18 per 1,000 traffic injury emergency department visits in 2010 to 1.01 visits in 2021.

    To be sure, cannabis-involved traffic injuries made up a small fraction of all traffic injury-related visits to hospital emergency departments. Out of 947,604 traffic injury emergency department visits, 426 had documented cannabis involvement.

    Myran cautions the increase shouldn’t be solely attributed to marijuana legalization. It captures changing societal attitudes toward marijuana and acceptance of cannabis use over time in the lead-up to legalization. In addition, it may reflect an increasing awareness among health care providers about cannabis-impaired driving, and they may be more likely to ask about cannabis use and document it in medical charts, he says.

    “When you look at the 475% increase in cannabis involvement in traffic injuries, rather than saying legalizing cannabis has caused the roads to be unsafe and is a public health disaster, it’s that cannabis use appears to be growing as a risk for road traffic injuries and that there seem to be more cannabis impaired drivers on the road,” Myran says. “Legalization may have accelerated this trend. Faced with this increase, we need to think about what are public health measures and different policy interventions to reduce harms from cannabis-impaired driving.”

    Setting a legal limit for marijuana-impaired driving

    Setting a legal limit for marijuana-impaired driving has not been easy. Countries like Canada and some U.S. states have agreed upon a certain level of THC in blood, usually between 1 to 5 nanograms per milliliter. Still, some studies have found those limits to be weak indicators of cannabis-impaired driving.

    When Canada legalized recreational marijuana in 2018, it also passed a law that made it illegal to drive with blood THC levels of more than 2 nanograms. The penalties are more severe for blood THC levels above 5 nanograms. The blood test is done at the police station for people who are pulled over and are deemed to be drug impaired.

    In the U.S., five states — Ohio, Illinois, Montana, Washington and Nevada — have “per se laws,” which set a specific amount of THC in the driver’s blood as evidence of impaired driving, according to the National Conference of State Legislatures. That limit ranges between 2 and 5 nanograms of THC per milliliter of blood.

    Colorado, meanwhile, has a “permissible inference law,” which states that it’s permissible to assume the driver was under the influence if their blood THC level is 5 nanograms per milliliter or higher, according to NCSL.

    Twelve states, most which have legalized some form of marijuana of use, have zero tolerance laws for any amount of certain drugs, including THC, in the body.

    The remaining states have “driving under the influence of drugs” laws. Among those states, Alabama and Michigan, have oral fluid roadside testing program to screen drivers for marijuana and other drugs, according to NCSL.

    In May this year, the U.S. Department of Transportation published a final rule that allows employers to use saliva testing for commercially licensed drivers, including truck drivers. The rule, which went into effect in June, sets the THC limit in saliva at 4 nanograms.

    Saliva tests can detect THC for 8 to 24 hours after use, but the tests are not perfect and can results in false positives, leading some scientists to argue against using them in randomly-selected drivers.

    In a 2021 report, the U.S. National Institute of Justice, the research and development arm of the Department of Justice, concluded that THC levels in bodily fluids, including blood and saliva “were not reliable indicators of marijuana intoxication.”

    Studies on marijuana and driving

    Over the past two decades, many studies have shown marijuana use can impair driving. However, discussions about what’s the best way to measure the level of THC in blood or saliva are ongoing. Below, we highlight and summarize several recent studies that address the issue. The studies are listed in order of publication date. We also include a list of related studies and resources to inform your audiences.

    State Driving Under the Influence of Drugs Laws
    Alexandra N. Origenes, Sarah A. White, Emma E. McGinty and Jon S. Vernick. Journal of Law, Medicine & Ethics, July 2024.

    Summary: As of January 2023, 33 states and D.C. had a driving under the influence of drugs law for at least one drug other than cannabis. Of those, 29 states and D.C. had a law specifically for driving under the influence of cannabis, in addition to a law for driving under the influence of other drugs. Four states had a driving under the influence of drug laws, excluding cannabis. Meanwhile, 17 states had no law for driving under the influence of drugs, including cannabis.  “The 17 states lacking a DUID law that names specific drugs should consider enacting such a law. These states already have expressed their concern — through legislation — with drug-impaired driving. However, failure to name specific drugs is likely to make the laws more difficult to enforce. These laws may force courts and/or law enforcement to rely on potentially subjective indicators of impairment,” the authors write.

    Associations between Adolescent Marijuana Use, Driving After Marijuana Use and Recreational Retail Sale in Colorado, USA
    Lucas M. Neuroth, et al. Substance Use & Misuse, October 2023.

    Summary: Researchers use data from four waves (2013, 2015, 2017 and 2019) of the Healthy Kids Colorado Survey, including 47,518 students 15 and older who indicated that they drove. They find 20.3% of students said that they had used marijuana in the past month and 10.5% said they had driven under the influence of marijuana. They find that the availability of recreational marijuana in stores was associated with an increased prevalence of using marijuana one to two times in the past month and driving under the influence of marijuana at least once. “Over the study period, one in ten high school age drivers engaged in [driving after marijuana use], which is concerning given the high risk of motor vehicle-related injury and death arising from impaired driving among adolescents,” the authors write.

    Are Blood and Oral Fluid Δ9-tetrahydrocannabinol (THC) and Metabolite Concentrations Related to Impairment? A Meta-Regression Analysis
    Danielle McCartney, et al. Neuroscience & Biobehavioral Reviews, March 2022.

    Summary: Commonly used THC measurements may not be strong indicators of driving impairment. While there is a relationship between certain biomarkers like blood THC concentrations and impaired driving, this correlation is often weak. The study underscores the need for more nuanced and comprehensive research on this topic, especially as cannabis usage becomes more widespread and legally accepted.

    The Effects of Cannabis and Alcohol on Driving Performance and Driver Behaviour: A Systematic Review and Meta-Analysis
    Sarah M. Simmons, Jeff K. Caird, Frances Sterzer and Mark Asbridge. Addiction, January 2022.

    Summary: This meta-analysis of experimental driving studies, including driving simulations, confirms that cannabis impairs driving performance, contrary to some beliefs that it might enhance driving abilities. Cannabis affects lateral control and speed — typically increasing lane excursions while reducing speed. The combination of alcohol and marijuana appears worse than either alone, challenging the idea that they cancel each other out.

    Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers
    Jeffrey R. Brubacher, et al. The New England Journal of Medicine, January 2022.

    Summary: Following the legalization of recreational marijuana in Canada, there was a notable increase in injured drivers testing positive for THC, especially among those 50 years of age or older. This rise in cannabis-related driving incidents occurred even with new traffic laws aiming to deter cannabis-impaired driving. This uptick began before legalization became official, possibly due to perceptions that cannabis use was soon-to-be legal or illegal but not enforced. The data suggests that while legalization has broad societal impacts, more comprehensive strategies are needed to deter driving under the influence of cannabis and raise public awareness about its risks.

    Cannabis and Driving
    Godfrey D. Pearlson, Michael C. Stevens and Deepak Cyril D’Souza. Frontiers in Psychiatry, September 2021.

    Summary: Cannabis-impaired driving is a growing public health concern, and studies show that such drivers are more likely to be involved in car crashes, according to this review paper. Drivers are less affected by cannabis than they are by alcohol or cocaine, but the problem is expected to escalate with increasing cannabis legalization and use. Unlike alcohol, THC’s properties make it challenging to determine direct impairment levels from testing results. Current roadside tests lack precision in detecting genuine cannabis-impaired drivers, leading to potential wrongful convictions. Moreover, there is a pressing need for research on the combined effects of alcohol and cannabis on driving, as well as the impact of emerging popular forms of cannabis, like concentrates and edibles. The authors recommend public awareness campaigns about the dangers of driving under the influence of cannabis, similar to those against drunk driving, to address misconceptions. Policymakers should prioritize science-based decisions and encourage further research in this domain.

    Demographic And Policy-Based Differences in Behaviors And Attitudes Towards Driving After Marijuana Use: An Analysis of the 2013–2017 Traffic Safety Culture Index
    Marco H. Benedetti, et al. BMC Research Notes, June 2021.

    Summary: The study, based on a U.S. survey, finds younger, low-income, low-education and male participants were more tolerant of driving after marijuana consumption. Notably, those in states that legalized medical marijuana reported driving after use more frequently, aligning with studies indicating a higher prevalence of THC detection in drivers from these states. Overall, while the majority perceive driving after marijuana use as dangerous, not all research agrees on its impairment effects. Existing studies highlight that marijuana impacts motor skills and executive functions, yet its direct correlation with crash risk remains debated, given the variations in individual tolerance and how long THC remains in the system.

    Driving Under the Influence of Cannabis: A Framework for Future Policy
    Robert M. Chow, et al.Anesthesia & Analgesia, June 2019.

    Summary: The study presents a conceptual framework focusing on four main domains: legalization, driving under the influence of cannabis, driver impairment, and motor vehicle accidents. With the growing legalization of cannabis, there’s an anticipated rise in cannabis-impaired driving cases. The authors group marijuana users into infrequent users who show significant impairment with increased THC blood levels, chronic users with minimal impairment despite high THC levels, and those with consistent psychomotor deficits. Current challenges lie in the lack of standardized regulation for drivers influenced by cannabis, primarily because of state-to-state variability and the absence of a federal statutory limit for blood THC levels. European nations, however, have established thresholds for blood THC levels, ranging from 0.5 to 50.0 micrograms per liter depending on whether blood or blood serum are tested. The authors suggest the combined use of alcohol and THC blood tests with a psychomotor evaluation by a trained professional to determine impairment levels. The paper stresses the importance of creating a structured policy framework, given the rising acceptance and use of marijuana in society.

    Additional research

    Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization
    Daniel T. Myran, et al. JAMA Network Open, September 2023.

    Driving Performance and Cannabis Users’ Perception of Safety: A Randomized Clinical Trial
    Thomas D. Marcotte, et al. JAMA Psychiatry, January 2022.

    Medicinal Cannabis and Driving: The Intersection of Health and Road Safety Policy
    Daniel Perkins, et al. International Journal of Drug Policy, November 2021.

    Prevalence of Marijuana Use Among Trauma Patients Before and After Legalization of Medical Marijuana: The Arizona Experience
    Michael Levine, et al. Substance Abuse, July 2021.

    Self-Reported Driving After Marijuana Use in Association With Medical And Recreational Marijuana Policies
    Marco H. Benedetti, et al. International Journal of Drug Policy, June 2021.

    Cannabis and Driving Ability
    Eric L. Sevigny. Current Opinion in Psychology, April 2021.

    The Failings of per se Limits to Detect Cannabis-Induced Driving Impairment: Results from a Simulated Driving Study
    Thomas R. Arkell, et al. Traffic Injury Prevention, February 2021.

    Risky Driving Behaviors of Drivers Who Use Alcohol and Cannabis
    Tara Kelley-Baker, et al. Transportation Research Record, January 2021.

    Direct and Indirect Effects of Marijuana Use on the Risk of Fatal 2-Vehicle Crash Initiation
    Stanford Chihuri and Guohua Li. Injury Epidemiology, September 2020

    Cannabis-Impaired Driving: Evidence and the Role of Toxicology Testing
    Edward C. Wood and Robert L. Dupont. Cannabis in Medicine, July 2020.

    Association of Recreational Cannabis Laws in Colorado and Washington State With Changes in Traffic Fatalities, 2005-2017
    Julian Santaella-Tenorio, et al. JAMA Internal Medicine, June 2020.

    Marijuana Decriminalization, Medical Marijuana Laws, and Fatal Traffic Crashes in US Cities, 2010–2017
    Amanda Cook, Gregory Leung and Rhet A. Smith. American Journal of Public Health, February 2020.

    Cannabis Use in Older Drivers in Colorado: The LongROAD Study
    Carolyn G. DiGuiseppi, et al. Accident Analysis & Prevention, November 2019.

    Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado
    Jayson D. Aydelotte, et al. American Journal of Public Health, August 2017.

    Marijuana-Impaired Driving: A Report to Congress
    National Highway Traffic Safety Administration, July 2017

    Interaction of Marijuana And Alcohol on Fatal Motor Vehicle Crash Risk: A Case–Control Study
    Stanford Chihuri, Guohua Li and Qixuan Chen. Injury Epidemiology, March 2017.

    US Traffic Fatalities, 1985–2014, and Their Relationship to Medical Marijuana Laws
    Julian Santaella-Tenorio, et al. American Journal of Public Health, February 2017.

    Delays in DUI Blood Testing: Impact on Cannabis DUI Assessments
    Ed Wood, Ashley Brooks-Russell and Phillip Drum. Traffic Injury Prevention, June 2015.

    Establishing Legal Limits for Driving Under the Influence of Marijuana
    Kristin Wong, Joanne E. Brady and Guohua Li. Injury Epidemiology, October 2014.

    Cannabis Effects on Driving Skills
    Rebecca L. Hartman and Marilyn A. Huestis. Clinical Chemistry, March 2014.

    Acute Cannabis Consumption And Motor Vehicle Collision Risk: Systematic Review of Observational Studies and Meta-Analysis
    Mark Asbridge, Jill A. Hayden and Jennifer L. Cartwright. The BMJ, February 2012.

    Resources for your audiences

    The following resources include explainers from federal agencies and national organizations. You’re free to use images and graphics from federal agencies.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Resistance Is Useful! (Especially As We Get Older)

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    Resistance Is Useful!

    At 10almonds we talk a lot about the importance of regular moderate exercise (e.g. walking, gardening, housework, etc), and with good reason: getting in those minutes (at least 150 minutes per week, so, a little over 20 minutes per day, or 25 minutes per day with one day off) is the exericise most consistently linked to better general health outcomes and reduced mortality risk.

    We also often come back to mobility, because at the end of the day, being able to reach for something from a kitchen cabinet without doing oneself an injury is generally more important in life than being able to leg-press a car.

    Today though, we’re going to talk about resistance training.

    What is resistance training?

    It can be weight-lifting, or it can be bodyweight exercises. In those cases, what you’re resisting is gravity. It can also be exercises with resistance bands or machines. In all cases, it’s about building and/or maintaining strength.

    Why does it matter?

    Let’s say you’re not an athlete, soldier, or laborer, and the heaviest thing you have to pick up is a bag of groceries. Strength still matters, for two main reasons:

    • Muscle strength correlates to bone strength. You can’t build (or maintain) strong muscles on weak bones, so if you take care of your muscles, then your body will keep your bones strong too.
      • That’s assuming you have a good diet as well—but today’s not about that. If you’d like to know more about eating for bone health though, do check out this previous article about that!
    • Muscle strength correlates to balance and stability. You can’t keep yourself from falling over if you are physically frail.

    Both of those things matter, because falls and fractures often have terrible health outcomes (e.g., slower recovery and more complications) the older we get. So, we want to:

    • Ideally, not fall in the first place
    • If we do fall, have robust bones

    See also: Effects of Resistance Exercise on Bone Health

    How much should we do?

    Let’s go to the Journal of Strength and Conditioning Research on this one:

    ❝There is strong evidence to support the benefits of resistance exercise for countering many age-related processes of sarcopenia, muscle weakness, mobility loss, chronic disease, disability, and even premature mortality.

    In addition, this Position Statement provides specific evidence-based practice recommendations to aid in the implementation of resistance exercise programs for healthy older adults and those with special considerations.

    While there are instances where low-intensity, low-volume programs are appropriate (i.e., beginning programs for individuals with frailty or CVDs), the greatest benefits are possible with progression to moderate to higher intensity programs.❞

    ~ Fragala et al

    Read the statement in full:

    Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association

    There’s a lot of science there and it’s well worth reading if you have the time. It’s particularly good at delineating how much is not enough vs how much is too much, and the extent to which we should (or shouldn’t) train to exhaustion.

    If you don’t fancy that, though, and/or just want to start with something accessible and work your way up, the below is a very good (and also evidence-based) start-up plan:

    Healthline’s Exercise Plan For Seniors—For Strength, Balance, & Flexibility

    (it has a weekly planner, step-by-step guides to the exercises, and very clear illustrative animations of each)

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